Prevention and management of aggression in ... - WorkSafe Victoria

5.Policy, procedures and practiceWork procedures need to:• describe circumstances in which they are to be followed• define roles and responsibilities• describe specific risk controls and monitoring of the controls• include emergency response arrangements, and• provide guidance on reporting of incidents and near misses.Clinical protocols should also be implemented to manage clinical aggressionarising from a client’s medical or psychiatric condition. Clinical aggression requiresa clinical response for prevention and management.Examples of procedures and practices relevant to the prevention andmanagement of aggression could include:• reporting incidents and near misses• limiting the number of client support people/visitors• communicating with clients and visitors to detail expected waiting times,client condition, treatments or treatment delays• cultural awareness and the appropriate use of interpreters• exchange of relevant information within and external to the organisation• use of lanyards with a safety breakaway• supply of security equipment such as duress alarms, and• searching clients and visitors for weapons, illegal drugs or alcohol.A procedure will be required to determine how to search an individual forweapons and other dangerous objects. The facility should determine conditionsof entry and clearly define weapons, alcohol and illegal drugs that are not to bebrought into the facility.Searching individuals and removing dangerous items creates a potential risk tostaff safety and should be undertaken by trained security personnel or, in somecircumstances, by police, but not clinicians.5.4 Behavioural risk factorsThe most reliable predictor for the likely occurrence of violence is previous violentbehaviour. To prevent the risk of injury to staff and others, clients with a historyof aggression or violence should be identified, risk assessed and the resultantinformation effectively communicated to staff and other service providersas required.Staff should be provided with the resources to identify and assess behaviouralrisks and to determine if any violent or aggressive behaviour has occurred inthe past.At presentation, the following risk factors should be considered:• current status (e.g. under influence of alcohol and/or drugs)• current level of aggressive behaviour• unwelcome treatment, pain and/or anxiety• long waiting time• information provided by family, friends or other service providers, and• history of aggression and violence.WorkSafe Victoria Handbook / Prevention and management of aggression in health services 23